The Predictive Value of Emotion Regulation in Cocaine Use Disorder Severity: Psychotherapeutic Implications During Hospitalization for Detoxification

IF 2.7 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical psychology & psychotherapy Pub Date : 2025-09-22 DOI:10.1002/cpp.70155

Alba Palazón-Llecha, Joan Trujols, Mercè Madre, Santiago Duran-Sindreu, Francesca Batlle, Núria Mallorquí-Bagué

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引用次数: 0

Abstract

Objective

Traditional treatment approaches in cocaine use disorder (CUD) still report high rates of poor outcomes. Emotion regulation (ER) is a transdiagnostic factor that may contribute to the initiation and maintenance of CUD, strengthening addiction severity. A deeper understanding of ER in this population is crucial for improving treatment outcomes. This study explores whether ER difficulties at treatment entry predict addiction severity and withdrawal symptom severity after discharge in patients with CUD. Secondarily, it examines whether withdrawal symptom severity mediates the relationship between ER difficulties and relapse.

Methods

A total of 70 CUD patients underwent a 14-day inpatient detoxification. At admission, cocaine use–related variables and ER questionnaires (DERS and ERQ) were registered. After discharge, addiction severity (SDS), craving (WCS), cocaine withdrawal symptom severity (CSSA) and relapse were recorded. Multiple linear regression and mediation analysis were conducted to address the primary and secondary aims, respectively. This study draws on data from a larger randomized clinical trial.

Results

Impulse control difficulties and nonacceptance of emotional responses predicted SDS, and nonacceptance of emotional responses predicted CSSA. However, mediation analyses showed no indirect effect of DERS total score on relapse through the effect of the mediating variable CSSA.

Conclusion

ER screening at hospitalization admission may optimize treatment by identifying high-risk CUD patients. Third-generation therapies targeting ER skills may enhance outcomes by helping patients manage emotional distress, potentially reducing addiction severity and withdrawal symptoms. Because of mixed results and the exploratory nature of this study, further research on the ER role in this context is needed.

Trial Registration: ClinicalTrials.gov; ID: NCT05207228.

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情绪调节对可卡因使用障碍严重程度的预测价值：戒毒住院期间的心理治疗意义

目的可卡因使用障碍（CUD）的传统治疗方法仍有较高的不良预后率。情绪调节（ER）是一种跨诊断因素，可能有助于CUD的发生和维持，增强成瘾程度。深入了解这一人群的内源性雌激素对于改善治疗效果至关重要。本研究探讨进入治疗时的ER困难是否能预测CUD患者出院后的成瘾严重程度和戒断症状严重程度。其次，它检查戒断症状的严重程度是否介导急诊室困难和复发之间的关系。方法对70例CUD患者进行14天的住院戒毒治疗。入院时，登记可卡因使用相关变量和ER问卷（DERS和ERQ）。出院后记录成瘾程度（SDS）、渴望程度（WCS）、可卡因戒断症状严重程度（CSSA）及复发情况。多元线性回归和中介分析分别解决了主要和次要目标。这项研究利用了一项更大的随机临床试验的数据。结果冲动控制困难和情绪反应不被接受预测SDS，情绪反应不被接受预测CSSA。然而，中介分析显示，通过中介变量CSSA的作用，DERS总分对复发没有间接影响。结论住院时进行ER筛查可通过识别CUD高危患者来优化治疗。第三代针对内质网技能的疗法可能会通过帮助患者控制情绪困扰、潜在地降低成瘾严重程度和戒断症状来提高疗效。由于这项研究的结果好坏参半，并且具有探索性，因此需要进一步研究内质网在这方面的作用。试验注册：ClinicalTrials.gov；ID: NCT05207228。

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来源期刊

Clinical psychology & psychotherapy PSYCHOLOGY, CLINICAL-

CiteScore

6.30

自引率

5.60%

发文量

106

期刊介绍： Clinical Psychology & Psychotherapy aims to keep clinical psychologists and psychotherapists up to date with new developments in their fields. The Journal will provide an integrative impetus both between theory and practice and between different orientations within clinical psychology and psychotherapy. Clinical Psychology & Psychotherapy will be a forum in which practitioners can present their wealth of expertise and innovations in order to make these available to a wider audience. Equally, the Journal will contain reports from researchers who want to address a larger clinical audience with clinically relevant issues and clinically valid research.